PPT presentation
https://www.dropbox.com/s/1xv3bok9jngzwnu/Throw%20away.pptx?dl=0
“Throw away” Energy and Reflexology charts for a
while.
Let’s have a
good look at feet anatomy and the physiology of what we are doing!
by Spiros Dimitrakoulas, Orthopedic Reflexologist (OR)
Competing interests - The author declares that he has no competing
interests.
I have chosen to
throw away energy and Reflexology charts for some simple reasons.
The matter of
energy because firstly the vast majority of scientists and physicians claim
that there is currently no conclusive evidence
that energy healing is more effective than placebo.1 The reason it works when it does is because CAM
practitioners spend a lot of time listening and expressing empathy – which is
probably their secret to success (not the “magical” properties of energy
healing) 2. This of course does not have a
negative effect on energy methods being incorporated into a hospital setting,
especially if we were to include praying for oneself or for others. 3
The
theory of the Reflexology charts is put aside initially because of the
inconsistent reflexology foot maps. 4
There are
many charts depicting the same reflex in different areas of the feet and
according to our claims and those of our clients they all work. Also because in
everyday practice experienced Reflexologists eventually will work the point(s)
they believe best despite their common training.5 Finally if we are working on a mirror
image of the body that is projected on the feet we must consider the anatomical variations that occur, for example heterotaxia.6
In order to
proceed we must first lay down some basics and a question, or at least I want
too.
Question: Is it
a “reflex” or a “reflection”?
1.
Ingham
made the claim that the application of reflexology massage to reflex points on
the feet increases blood supply to the corresponding mapped organs in the body.
In her teachings, the reflexology haemodynamic treatment-related effect is
thought to be distinct from non-specific foot massage components, such as
simple touch, therapeutic exchange and placebo effects, even though these
components can themselves cause haemodynamic responses. 7
2.
Ingham
described her technique as a “slow creeping rotary and slight pulling back
movement” 8
3.
The
duration is 20-30 minutes and for those trained in the method half that length
of time. 8 pg.29
4.
Our
clients are people with chronic, unexplained, and unresolved health issues;
they are desperate and willing to try anything to solve these issues.9
I use complementary medicine/therapy
because....
1.
Conventional medicine was not effective for my health
problem.
2. I believe that
complementary/alternative medicine allows me to take a more active role in
maintaining my health.
3. The conventional medicine
treatment I received had unpleasant side effects.
4. I value the emphasis that
complementary/alternative medicine places on treating the whole person.
5. I had difficulty communicating
with my medical doctor (for example, he/she didn't understand my problem,
didn't listen, etc.).
6. I am desperate to solve my health
problem and I will try anything.
5.
Science
is changing, classical theories are being challenged, how are we to prove
ourselves? 10,11
6.
Research
and its findings are biased to say the least.
“It is simply no longer possible to believe much of the clinical research that
is published, or to rely on the judgment of trusted physicians or authoritative
medical guidelines. I take no pleasure in this conclusion, which I reached
slowly and reluctantly over my two decades as an editor of The New England
Journal of Medicine.” Dr. Marcia Angell 12,13
The Heart
reflex
Jones
and Leslie of the Stirling University reported the inconsistencies in reflexology teaching literature regarding treatment
strategies and marked inconsistencies that exist in the heart reflex point
placement.14 Despite these inconsistencies there are Reflexologists and clients who
claim that they have witnessed Reflexology to be of benefit. The same authors also reported that reflexology
massage applied to the upper part of the left foot in the area thought to
relate to the 'heart' may have a modest specific effect on the cardiac index of
healthy volunteers, but no specific haemodynamic effect on patients with
various gradations of cardiovascular disease.15 Frankel also
noted that the
reflexology and foot massage groups
showed significantly greater reductions in Baroreflex Reflex Sensitivity
BRS compared to the control group.16
The baroreceptors are stretch-sensitive mechanoreceptors. The baroreflex provides a rapid negative feedback
loop in which an elevated blood pressure
reflexively causes the heart rate to decrease and also causing blood pressure
to decrease. Decreased blood pressure decreases baroreflex activation and
causes heart rate to increase and to restore blood pressure levels.
Hypotheses
Jones and
Leslie asked the Reflexologists to administer treatment in the upper part of
the left foot compared to the control group who focused on the heel. If we
observe the anatomy of the plantar foot we will see that there exist more and
larger arteries in the first area compared to the control. If for example there
is “constriction - stiffness” of the tissues in this area of the foot
(metatarsal bones) this could possibly lead to arterial stiffness which would
lower BRS thus increase systolic arterial
pressure SAP. If someone were to release the “constrictions – stiffness” this
would alter the BRS and thus lower the SAP. This has been examined with different
exercise training.17
Referral areas – Cross
reflexes
Ingham in her
book Stories the feet can tell pg. 99 suggests the use of referral areas and
the evolvement of this idea is cross reflexes. The earliest documentation of
this idea was probably by Celsus in his book De Medicina.18
Through research
it has been observed that in unilateral tendinopathy
sensory and motor systems present deficits bilaterally. This implies potential
central nervous system involvement. This indicates that rehabilitation should
consider the contralateral side of patients.19 Also there is indirect
evidence to indicate that neural adaptations accompany resistance training from
the phenomenon of 'cross education', which describes the strength gain in the
opposite, untrained limb following unilateral resistance training. It has been
estimated that the magnitude of cross education is approximately equal to 7.8%
of the initial strength of the untrained limb.20 There is also Interlimb coordination
(Crossed extension reflex) which primarily involves movements
requiring sequential and simultaneous use of both sides of the body with a high
degree of “rhythmicity”. More precisely, it involves the timing of motor cycles
of the limbs in relation to one another (Swinnen & Carson, 2002). Such
actions are commonly divided into two categories: bimanual coordination and coordination
of hands/feet.
Somatosensory ascending
pathways carry peripheral sensations to the brain; the dorsal column system
and the spinothalamic tract are
two major pathways that bring sensory information to the brain. Stimuli from
the head and neck travel through the cranial nerves—specifically, the
trigeminal system. The dorsal column is separated into two component tracts,
the fasciculus gracilis that contains axons from the legs and
lower body, and the fasciculus
cuneatus (T6) that
contains axons from the upper body and arms. The dorsal column system is
primarily responsible for touch sensations and proprioception, whereas the
spinothalamic tract pathway is primarily responsible for nociception and
temperature sensations.
The second neurons in both of these pathways are
contralateral, because they project across the midline to the other side of the
brain or spinal cord. In the dorsal column system, this decussation takes place
in the brain stem; in the spinothalamic pathway, it takes place in the spinal
cord at the same spinal cord level at which the information entered.
The
explanation to this communication is still incomplete but definitely many lower
and higher central nervous system areas are involved.
Reflexology
significance: Cancer patients request CAM
treatments in order to “be in the driver’s seat” and Reflexologists teach them
to work on referral areas and cross reflexes and one would initially be tempted
to attribute any positive results to suggestion and placebo. But it is
interesting that this might work because the CNS evaluates not only the
affected limb but also the space/side the limb resides.21 Put simply, if you were to place your affected limb across the midline
of your body, or your healthy limb on the affected side this might spatially
confuse your brain and its output (pain) will also change. Maybe that’s how therapeutic knitting works also.
Diagonal reflexes
Besides an
existing neurological coordination of hands/feet based on a serial organization (communication between levels) of the motor system, there
exists also a myofascial explanation.
The Functional Lines,
according to Tom Myers, extend the Arm Lines across the surface of the trunk to
the contra lateral pelvis and leg and vice versa.. These lines are called the
'functional' lines because they are rarely employed, as the other lines are, in
modulating standing posture. They come into play primarily during athletic or
other activity where one
appendicular complex is stabilized, counterbalanced, or powered by its
contralateral complement. An example is when you throw a rock with your right hand;
you will power up through your left leg and hip to add extra speed to that
rock.
While the applications to
sport spring to mind when considering these lines, the essential example is the
contralateral counterbalance between shoulder and hip in every walking step. Excess
strain or immobility at any part along the line could lead to a progressive 'pile-up'
elsewhere on the line that could lead to problems over time. 'Silent'
restriction somewhere on any myofascial meridian, Reflex zone, Chinese meridian
could be creating 'noisy' problems elsewhere.22
Autogenic inhibition - Reciprocal
inhibition reflex
- Golgi Tendon Organs – muscle spindles
When we are offering
reflexology to our clients, their bodies are usually in a relaxed position and
no forces are acting on their feet, yet we still find painful reflex areas
accompanied with “deposits/crystals”. These reflex areas are located on muscles,
bones, tendons.
When we start working on these
reflex areas/muscles, at times we are applying low force ongoing tension and the
Golgi tendon organ (located between
the muscle belly and its tendon) at hand is activated. This stimulus will enter
the spinal cord and synapse onto an inhibitory
interneuron that will synapse onto the motor neuron of the muscle that
we had just activated. The end result will be a relaxation of this muscle
(reflex inhibition) and a contraction of the antagonist muscle. This process is
called autogenic inhibition and it
is seen during static, low force, 7-10 second duration stretching.
At another moment or reflex we
might apply a sudden “sharp” and still stretching stimulus. The muscle spindle,
which is located within the muscle belly and stretches along with the muscle,
will be activated (stretch reflex)
and now cause a reflexive contraction of the reflex/muscle we had just
stimulated and relax the antagonist muscle. This process is called reciprocal
inhibition. The patellar reflex or knee-jerk is such a reflex and the grading
response is indicative of possible abnormalities. Similar to this would be a
positive Babinski sign in adults, the hallux dorsiflexes and the other
toes fan out, which should lead us to considering the respected spinal level and all associated structures.
Reflexology significance of GTO’s
Because GTO’s are inhibitory by
nature, stimulating those in the feet triggers a relaxation generated at the
local spinal reflex (L4-S2), and reduces nerve activity in the associated
organs and muscles. This has the potential to create many positive, local
effects. If we hold the pressure long enough the GTOs have a substantial
inhibitory — relaxing or defacilitating — effect in the brainstem also. Then,
you get a more systemic effect of relaxing/healing the entire system. Also
worth mentioning is the case when reflexes/muscles in the sole of the
foot do not relax/loosen with our direct techniques. Something we may try, is
to work on the dorsal muscles/reflexes, “front – back” relationship.23 Finally, if you
have a “tight” foot reflex/muscle you might want to work on the GTO’s, but in
the case of a loose/weak foot reflex/muscle you might want to work on the
muscle spindles.
Pfluger's Laws +2 more
Eduard Friedrich Wilhelm Pflüger (7 June 1829 – 16 March 1910) was a
German physiologist born in Hanau.
The law
of unilaterally: if a mild stimulus is applied to
one or more sensory nerves the movement will take place usually on one side
only and on the side that was irritated (zone therapy)
The law
of symmetry: if the stimulation significantly increases (nociception) motor reactions
will manifest not only on the stimulated side but also similar muscles of the contra
lateral side. (cross reflexes)
The law
of radiation: If excitation continues to increase it is propagated upward and the
reaction takes place through efferent/centrifugal nerves coming from the cord
segments higher up.
The law
of generalization: when irritation becomes very
intense it is propagated in the medulla oblongata which becomes a focus from
which stimuli radiate to all parts of the cord causing general contraction of
the muscles of the entire body.
+2
The Physiological Law of Facilitation (the path of least resistance): When an impulse has passed once
through a certain set of neurons in your brain to the exclusion of others, it
will tend to take the same course on a future occasion, and each time it does,
the resistance will become less. Pain does this also!
Arndt-
Shultz Law-Weak
stimuli (stroking) activate physiological processes. Very strong stimuli
inhibit them.
Reflexology significance
Initial stimulus
will have an effect on the respected spinal level and its associated structures
on the same side (intense stimuli - contralateral side) thus of benefit for one
specific issue. Persistent and continuous stimulus will radiate (-tion law) to
higher levels effecting the CNS, and even more stimulus will have a general
(-zation law) effect on all the body. Keeping in mind that most of our clients
are dealing with multiple issues and chronic pain, and that their pain is a
product of the law of facilitation, we can utilize this same law to the benefit of our client.
Arndt- Shultz Law, cited mostly by homeopaths, may be a good guideline for us
according to recent research findings.28 The generalized
inhibitory affect in the overall system through hands, feet and the face, are
due to them offering the largest amount of sensory information, large amount of
nerve endings and largest areas in the homunculus are present.
Wolff's law and Nerve Reflexology (NR works primarily on the periosteum):
Wolff's law states that bone in a healthy person
or animal will adapt to the loads under which it is placed. If loading on a particular bone
increases, the bone will remodel itself over time to become stronger to resist
that sort of loading. If this continues calcium is laid down along lines of stress (zones,
muscle chains, meridians) resulting in bony spurs, joint immobility and
calcified ligaments. The inverse is true as
well.
Reflexology significance – Dr. Hans Selye and the general adaptation syndrome: A stressor has been placed on the body causing an alarm reaction; if this
goes on what follows will be the adaptative stage (clear positive reflexes), if
the adaptations remain this will eventually lead to the stage of exhaustion
leading to the feeling of pain. The work we do with NR might also be affecting
this route, the opposite way of course.
Other spinal
reflexes
In the developing
vertebrate embryo, somites split to form dermatomes, skeletal muscle
(myotomes), tendons and cartilage
(syndetomes), neurotomes and bone (sclerotomes).
Due to an overlap of these structures in every segment
of the spinal cord (viscerosomatic convergence) these structures are
interacting/influencing positively and negatively. Viscerosomatic convergence does not only occur in the spinal cord or brain,
it also occurs in the dorsal root ganglion, the most peripheral part of the
CNS!
Some examples of how dysfunction in visceral
structures and somatic structures can influence the functionality of visceral
and somatic structures that are segmentally related are listed below:
Somato-somatic reflexes “Localized somatic stimulation produces patterns of
reflex response in segmental related somatic structures.”
Viscero-somatic reflexes “Localized visceral stimulation produces patterns of reflex response in
segmental related somatic structures.”
Somato- visceral reflexes “Localized somatic stimulation produces patterns of reflex response in
related visceral structures.”
“Nerves with a high neurovisceral portion are
involved, like the median nerve or the tibial nerve.” Book - Manual Therapy for
the peripheral nerves. Barral/Croibier
Viscero – cutaneous reflex “Localized visceral stimuli produce patterns of
reflex activity in segmentally related skin areas”.
Cutaneo – visceral reflex “Localized cutaneous stimuli produce patterns of
reflex activity in segmentally related visceral structures.”
Viscera – visceral reflex “Localized visceral stimuli produce patterns of
reflex activity in segmentally related visceral structures.”
Nociception
vs Pain - Gate Control Theory of Pain. – Closing the door of nociception.
Nociception
refers to the process through which information about peripheral stimuli is
transmitted by primary afferent nociceptors to the spinal cord, brainstem,
thalamus, and subcortical structures. In contrast, the experience of pain can
result only when there is activity of thalamocortical networks (brain/emotions
also) that process the information conveyed by pathways of nociception. In the spinal cord for the body and
the trigeminal nucleus for the head some interneurons make connections with
motor neurons that generate nociceptive withdrawal reflexes – discussed
previously. Pain is a product of higher brain center processing, whereas
nociception can occur in the absence of pain. 29
According to the gate
control theory, pain signals (nociception) are not free to reach the brain as soon as they are generated at the injured tissues
or sites. They need to encounter certain ‘neurological gates’ at the spinal
cord level and these gates determine whether nociception should reach the brain
or not. In other words, pain is perceived when the gate gives way to nociception
and it is less intense or not at all perceived when the gate closes for the
signals to pass through. This theory gives the explanation for why someone
finds relief by rubbing or massaging an injured or a painful area, or even
along its dermatome. There exists dermatome variability among us, and of course
there are significant variations in current
dermatome maps in standard anatomy texts 30, like the variations in our
reflexology charts.
When nociception carried by the small fibers (A-delta and C fibers) are
less intense compared to the other non-nociceptive sensory signals like touch,
pressure and temperature, the inhibitory neurons prevent the transmission of
the pain signals through the T cells. The non-nociceptive signals override the nociceptive
signals and thus the nociception is not perceived by the brain so it is not
evaluated. When the nociceptive signals are more intense compared to the non-
nociceptive signals, the inhibitory neurons are inactivated and the gate is
opened. The T cells transmit the nociceptive signals to the spinothalamic tract
that carries those signals to the brain. As a result, the neurological gate is
influenced by the relative amount of activity in the large and the small nerve
fibers.24
Reflexology significance - When a client whishes for us to address their pain,
besides utilizing Dr. Fitzgerald’s zones or Chinese/Greek meridians, we can now
utilize a dermatome map also. All of them only as a guide, and respecting that
it is very likely that they might prove inaccurate for our given client. Light brisk
rubbing or thumb walking on zones, reflexes, meridians, dermatomes, myotomes,
sclerotomes may relieve the pain experienced by “closing the door/gate behind
us”.
Now utilizing this knowledge we can decide when
to use the feet, the hands, the face and the ears.
Diffuse noxious inhibitory control (DNIC) is commonly known as counter irritation. This phenomenon goes back to the
Hippocratic aphorism: “If two sufferings take place at the same time, but at
different points, the stronger makes the weaker silent”.
Neurones in the dorsal horn of the spinal cord were found to be
inhibited when a nociceptive stimulus is applied to any part of the body that
is distinct from the excitatory receptive fields of the dorsal horn neurones
that are inhibited (hence the origin of the term “diffuse” as opposed to the
similarly observed hypoalgesic effects of painful stimulation to the same
segmental region of the body, as for instance during transcutaneous electrical
nerve stimulation). This “pain
inhibiting pain” effect is well known from folk medicine across many
cultures. Indeed, in early surgical procedures on humans and animals this
concept was harnessed without realization of the underlying mechanisms (for
example, use of the twitch in horses and nasal forceps in cattle during
caudectomies or castrations which are both potentially very painful
procedures). Many stressful stimuli are able to produce such counterirritation
which has led to the term “stress induced analgesia”. 36
Reflexology for central nervous system (CNS) sensitization, preprioception, intrinsic (reflexology) muscles
CNS sensitization is the situation where an individual has pain lasting longer than 3-6 months and that can last for years. There is
no injured tissue, healing times have surpassed, and thus there are no true
noxious stimuli - nociceptive input. A sensitized patient actually feels pain;
it is not from the periphery anymore but rather from within the CNS, “it’s in their head”! Due to the
presence of pain, a lack of movement will follow with the hope that this
strategy will generate less pain. This lack of movement will tend to blur the
CNS maps (homunculus) also called sensory motor amnesia SMA. Common areas for
SMA are the feet, hip joints and upper thorax. On the basis of experiments, many experts believe that
gaps, smudges, or other inaccuracies in the body maps can be a significant
contributing factor in many chronic pain conditions, and that fixing these problems is a
potential way to cure pain.25
Characteristic
of these patients are increased
sensitivity to light, touch, noises, pesticides or temperature. Sleep
disturbances, swollen feeling, tingling numbness and/or poor concentration have
shown to be associated.
Proprioception is the brain’s ability to sense the
relative positions and movements of the different body parts. The key to
understanding proprioception is the body maps. Each part of the body has a
separate area of the brain dedicated to moving and sensing that body part. So,
we have feet, and we have virtual feet in the brain – parts of the brain that
represent the size, shape and position of the feet. When mechanoreceptors in the feet are stimulated by a
mechanical force (reflexologists hands), they send a signal through the nervous
system to the part of the brain devoted to sensing that part of the body. Research has found that plantar massage and
joint mobilization of the feet and ankles has a positive impact on balance in the
elderly. 31
Movements that are most likely to lead to changes in the quality of the
maps are movements that are curious, exploratory, novel, interesting, rich in
sensory input, slow, gentle, mindful, non-painful. Ingham – small creeping movement. 26
Motor
mental ability/disability
In normal infants developmental milestones such as eye
– hand coordination and visual tracking occur at predictable ages. Intellectual
development and motor development go together, consider the presence of
primitive reflexes in a new born which would control gross movements. These
primitive reflexes normally fade away as the child’s nervous system develops
giving rise to fine motor control, like picking up an object with your thumb
and index finger – intrinsic
muscles/reflexology muscles!
Hypotheses
Chronic pain may lead or be associated to CNS
sensitization. These higher levels from where pain is expressed are in charge
of fine movement too, which in turn is expressed through intrinsic muscles that
also exist in our feet/hands. When we apply Reflexology, like it or not, we are
also offering stimulus to the maps, possibly readjusting the maps and desensitizing
the CNS. Also of importance, is that the body relies a great deal on the
mechanoreceptors of the feet for proprioception adjusting in turn its entire posture
accordingly. In both cases it is like formatting your pc.27
Why does Lynne Booth’s VRT and zonal triggers work?
One aspect of
vertical reflexology is treating the client in a standing – weight bearing
position, where all
the reflexes can be accessed through the dorsum of the foot. Initially the first VRT treatments
were directed towards orthopedic problems and this is where Lynne saw her first
positive results. Having to do with an explanation for these
positive results Lynne states
“I propose that VRT puts
the body into a neutral state where the long-term legacy of strain, tension,
degeneration or scar tissue in its systems is bypassed to allow direct access
to the original problem.”
Noticeable is also that “The
client will also observe that the feet feel much more tender when worked in a
weight-bearing position, and the therapist should be aware of this factor and
decrease the pressure accordingly.”32
In my opinion the
advantage of VRT compared to a normal Reflexology session is that the client is
in the weight bearing position but not because it is in neutral state, as I
understand it (nonaligned,
disengaged state) rather because it is in the exact opposite state. When we
are weight bearing our body is aligned and engaged for movement, or even for
keeping us standing still (kinetic chains/ myofascial chains, meridians,
zones), and is this not the time when most people have pain? I find it only
natural that our client’s positive reflexes (disturbed reflex presents pain
and/or “finding”) will appear, or at least appear differently when they are
weight bearing then compared to when they are lying down as in the usual
Reflexology position. This could also
explain the larger perception of tenderness felt by the client in this
position.
“The zonal triggers (ZTs) are
deep ankle reflexes that play an important role in activating the zones extremely
quickly so that the body is more receptive to healing.” In my opinion I believe the ZT area is of great
importance, standing or lying down, because of the inferior extensor
retinaculum (the superior is of importance also), the superior - inferior peroneal
retinaculum and the flexor retinaculum.
A retinaculum is a band like
thickening of the deep fascia in distal portions of the limbs that holds
tendons in positions when muscles contract. Though muscles have a relatively straight line of
pull, the muscles of the distal extremities are much different. The long
extensors of the toes are a good example. They travel the length of the lower
leg and then over the top of the foot they take close to a 900 angle
bend over the top of the foot near the ankle joint to the toes. The retinaculum
is there in order for these tendons to be mechanically efficient and held close
to the joint. If they weren’t there would be a tendency for the tendons to be
pulled away from the joint when the muscle contracted. Due to repetitive motion/friction, sprains, postural compensation
patterns, or compression during movement tenosynovitis, fibrous adhesions or a
roughening of the surface between the tendon and its sheath may develop. There
is a common tenosynovitis condition that develops over the top of the foot
where the long extensors of the toes pass under the extensor retinaculum called
“lace bite” because tight shoelaces are often the primary cause.
By the 'everything-connects-to-everything-else' fascial principle, the Superficial Front Line (SFL) connects
the entire anterior surface of the body from the top of the feet to the side of
the skull in two pieces -toes to pelvis and pelvis to head - which, when the
hip is extended as in standing, function as one continuous line of integrated
myofascia. So releasing existing adhesions
between the tendon and its sheath in this ZT area will have an effect on the
SFL, or zones, or meridians, or reflexes. Interestingly Tom Myers states, “The need to create sudden and
strong flexion movements at the various joints requires that the muscular
portion of the SFL contain a higher proportion of fast-twitch muscle fibers.” ,
could this be the reason Lynne states “…that the body is more responsive to a healing and
energetic stimulation when treated briefly in a standing position.”?
Why does Ingham’s chronic reflex area
for sciatica, reproduction and rectum work and what’s the connection with SP6 –
Sanyinjiao or Three ladies having tea?
In the section Rectal Disorders page 84, “Stories the
feet can tell” Eunice tells us “…we will find this reflex on the inner side
of each ankle about half an inch from the cord leading up the back of the leg.
The tenderness here may extend three to five inches up from the heel...”
Spleen 6 is the point at which the Spleen, Liver and
Kidney meridians intersect, hence the name, Three Yin Intersection or three
ladies having tea. Indicated for anything gynecological, reproductive
health in men, painful urination, insomnia, dizziness, low back and knee pain, digestive disorders. (ORGANS!!!!)
Tom Myers approach places this area/reflex point as a part of the Deep
Front Line DFL. The three structures
at hand would be the posterior tibialis, flexor digitorum longus and flexor
hallicus longus, and they account for the deep posterior compartment (Yin). The myofascial structures of the
DFL accompany the extensions of the viscera (organs) into the limbs.
They can only be palpated directly just above the ankle. Tibial nerve is
also entering the tarsal tunnel and so is tibial artery. Anatomy Trains Myofascial
Meridians
So, if this
reflex area is positive to work on, what issues might we be positively
affecting according to Tom Myers?
Any feet
problems (arches, cramps), deep calf muscles (tiredness, cramps), knee
(capsule, back of knee popliteus, medial femoral epicondyle), adductor issues
(abdominal syndrome), hemorrhoids, pelvic floor issues, psoas, all organs, diaphragm, pericardium, scalene muscles, neck
muscles, tongue.
Placebo
Non-specific low back pain
symptoms seem to improve in a
similar pattern in clinical trials following a wide variety of active as well
as inactive treatments. It is important to explore factors other than the treatment
that might influence symptom improvement. The placebo treatment/waiting list control/no treatment group
didn’t differ from the treatment groups. 33, 34
“It ain’t what you do it’s the way that you do
it, and that’s what gets results”
The Reflexology
problem at the Aretaieio Hospital Pain Clinic
Touch
Neural correlates of a single-session massage treatment
In contrast, the massage with a wooden object, which
involved pressure and strokes along the same areas of the foot as applied in
the Swedish massage, had no significant effect on the BOLD signal in either of
the brain regions. This latter finding is particularly noteworthy since it
suggests the possibility that the human touch component (as opposed to the same
pattern of massage with an object) had a profound influence upon the impact of
the treatment. It is important to note that the massage with the object may not
have activated the foot’s muscle receptors as strongly as the reflexology
and/or Swedish massage. 35
Understanding the role of stimulation in
reflexology: development and testing of a robotic device
I believe the most
significant benefit that massage (Reflexology) can offer this person is
comfort. I believe that my greatest gift to this person is my ability to use
touch to remind her that her body can still be a source of joy. That she can
still feel pleasure; that her body is still a good place to be. 37 Kerry Jordan
Spiros Dimitrakoulas - http://spiros-reflexologia.blogspot.gr/
1.
Practicing Reiki does not appear to routinely produce high-intensity
electromagnetic fields from the heart or hands of Reiki practitioners.
3. 2010 COMPLEMENTARY AND ALTERNATIVE MEDICINE SURVEY OF
HOSPITALS
4. Reflexology has
an acute (immediate) haemodynamic effect in healthy volunteers: a double-blind
randomised controlled trial. http://www.ncbi.nlm.nih.gov/pubmed/23072264
5. Reported
treatment strategies for reflexology in cardiac patients and inconsistencies in
the location of the heart reflex point: an online survey. http://www.ncbi.nlm.nih.gov/pubmed/22789788
6.
https://www.painscience.com/articles/anatomical-variation.php
7. Reflexology –
Science or Belief (Jones, Leslie)
8. Stories the
feet have told pg 21 – Stories the feet can tell pg 9.
9. Motivations for consulting complementary
and alternative medicine practitioners: A comparison of consumers from 1997–8
and 2005 http://www.biomedcentral.com/1472-6882/8/16
16. The effect of reflexology on
baroreceptor reflex sensitivity, blood pressure and sinus arrhythmia
17. Arterial stiffness
and baroreflex sensitivity following bouts of aerobic and resistance
exercise.
18. English translation paragraph 14 –p177
http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Celsus/2*.html
19. http://www.ncbi.nlm.nih.gov/pubmed/24144533
20.
http://www.ncbi.nlm.nih.gov/pubmed/17190532
21.
http://www.ncbi.nlm.nih.gov/pubmed/19752177
22. Anatomy Trains
Myofascial Meridians for Manual and Movement Therapists, 2nd Edition. By Thomas
W. Myers
How does foot reflexology works? A hypothesis.
If we ask: “how does foot reflexology works”, we have to agree on one thing. It has to be the nervous system that transfers the stimulus on the foot to the target organ. This means that the stimulus on the foot is transferred to the spinal cord by peripheral nerves and from there to the brain by ascending tracts or ascending pathways. Somewhere in the brain the stimulus is transferred back to the spinal cord by descending tracts or descending pathways and by peripheral nerves to the organ. In other words: in these areas in the brain where the ascending stimulus from the foot arrives, there must be an overlap with the descending tracts that go to the specific organ.
Lets look at these different steps and see if we can get enough science-based materials for this hypothesis.
1. The stimulus from the foot to the spinal cord.
When we are bringing in stimuli on the foot by thumb, fingers or other materials we are stimulating different nerve endings. We agree that the stimuli are firm but not that powerful that it causes pain under normal conditions. So, we are stimulating mechanical nerve endings in the skin, connective tissue, muscles and tendons of the foot. These mechanical nerve endings are encapsulated nerve endings like Merkel or Vater-Paccini nerve endings. The nerves that transfer these stimuli to the spinal cord are of the A-alfa, -A-bèta and A-delta1 type = fast conducting, myelinated nerves. The peripheral nerves that transfer these stimuli to the spinal cord are: Tibial and peroneal nerve reassembled in upper leg by the sciatic nerve. The sensory endings of the siactic nerve are entering the spinal cord at the levels of L4-S2. (Kahle, W, Leonherdt, H, and Platzer, W, 1986; Benninghoff, 1985)
2. Ascending pathways to the brain.
From the spinal cord levels L4-S2 two pathways are involved in transferring the stimuli to the brain: the dorsal pathways and the spinal-thalamic tracts.
2.1. The dorsal pathways
These pathways are converting directly to the lateral nuclei of the thalamus. On their way up to the brain this pathway is reassembling all mechanical information from mostly all the musculo-skeletal movement system (propriosensoric information).
On the other hand 10% of the nocisensoric information of organs is also reassembled in this pathway. Nocisensoric means: nerves that bring over information on tissue damage in organs. These nerves are C-nerves: slow conducting, non-myelinated nerves.
In the thalamus, especially in the VPL-nucleus (ventro-postero-lateral nucleus), nocisensoric (tissue damage) information from organs is coming together with propriosensoric (non-nocisensoric) of the musculo-skeletal system. (APKARIAN A et al, 1995)
What we know for sure is that in this nucleus there is a somatotopic organisation or homunculus in the VPL nucleus. This means: the whole body is reflected in nerve cells on exact anatomical reprint. (Figure 1). In this representation the C-fibers that are reporting tissue damage of organs are overlapping the propriosensors of the musculo-skeletal system like sheets overlapping each other.
Fig 1: VPL homunculus
From the lateral nucleus of the thalamus the dorsal pathways are going into the postcentral gyrus of the cortex. In this gyrus, there is also a “homunculus” or anatomical representation . (Fitzgerald, M. J. T., 1995; APKARIAN A et al, 1995)
Fig 2: homunculus in the sensory cortex
2.2. The spinothalamic tracts .
These pathways are divided in a lateral and a medial spinothalamic tract. The lateral tract transports predominantly Ab and Ad1 fibres while the medial tract transports Adand C-fibres, mostly nocisensoric, from both organs and musculo-skeletal system.
The lateral tract is emerging into the lateral side of the thalamus and from there to the postcentral gyrus of the cortex where they meet the nerves of the dorsal pathways.
The medial tract is emerging into the medial thalamus and from there to the postcentral and frontal gyrus of the cortex.
2.3. The spinal trigeminal nucleus and the sciatic nerve.
Propriosensors of the foot sole, transported by the sciatic nerve, are meeting propriosensors of the upper cervical spinal joints and muscles in the spinal trigeminal nucleus (brainstam-C2). This is necessary for a good general balance. This nucleus is closely related to the reticular formation in the brainstam, where musculo-skeletal nerve endings are meeting organ nerve endings. Also in the brainstem we find a homunculus representation of the body. (OSHIMA K et al, 2005)
3. How does foot reflexology works?
In the research literature we can find many reports that indicate thet in different parts of the brain there is a somatotopic representation of the body. In these homunculi Aa, Ab and Ad nerve endings of the musculo-skeletal system meets Ad and C- fibres of the organs. (DREWES et al, 2006; OGINO et al, 2005; OSHIMA K et al, 2005; LEE, 2002; APKARIAN et al, 2001; Fitzgerald, M. J. T., 1995; APKARIAN A et al, 1995)
Let us take an example of an inflammation of the stomach.
Ad en C- nocisensoric fibres will enter the dorsal horn of the spinal cord at the level of T6-T8 by sympathetic sensory nerves and in the brainstam by vagal nerves. Ascending pathways (see higher) will alarm the brainstam for neuro-endocrine changes, the thalamus for motor changes, the sensory and motor cortex for motor changes, the prefrontal cortex for psycho-emotional changes etc…
In the homunculi in these parts, these nerve endings will overlap the Aa,Ab and Ad of the stomach zone of the foot sole. These nerve endings are normally not pain sensitive. But, by the neurotransmittors of the stomach nerve endings, they will be sensitised and they will become painfull.
If we are stimulating the nerves of the stomach zone of the foot, we are stimulating the thick myelinated nerves and they will release neurotransmittors that are de-sensitising the nocisensoric fibres of the stomach and stimulate healing processes in the different parts of the brain for curing the stomach.
Conclusions.
We might say that there is enough science based evidence of how foot reflexology can work. However, these research papers are not talking about reflexology. They handle about other research goals. But, the conclusions of these studies might be extrapolated to reflexology. Real good research on how reflexology works are lacking. It seems that researchers are not interested or…there is no money. If all reflexology associations all over the world should ask their members to contribute 1 dollar or 1 Euro each year for this kind of scientific research, I am sure that in five years there will be enough money to pay a team or scientific researches to detect the neural pathways of reflexology. What are we waiting for???
Nico Pauly
